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The Good, the Bad and the Ugly
165 Plays1 year ago
Ciara is preggo 🤰🏾, Lizzo needs to give us a call, and Dr. Sunshine gives an immune system talk. 🦠
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Transcript
Meet the Hosts and Their Balancing Act
00:00:16
Speaker
Hey, guys. Welcome to another episode of Chocolate with a Side of Medicine. I am one of your hosts, Dr. Chris, and I'm joined by beautiful, lovely ladies. We got Amy Jo MD. What's up, y'all? And then we got Dr. Sunshine. Hey. And unfortunately, we don't have Dr. No-No here today because she's out here saving lives because that's what she does.
00:00:42
Speaker
So we gonna have to push on and do this episode without her, but she will be missed as always when she can't come because she has to save lives. Absolutely. Listen, y'all, we making hard decisions because behind the scenes, we're always trying to figure out how to pack these for real full-time jobs in and do this thing that we love and trying to get four doctors
00:01:09
Speaker
in the same place at the same time as like herding cats. So we're also very much committed to giving you all the product. So you're not coming to our page like, where's that next episode? We hear you. We see you. We feel you. So we
FOMO and Missed Opportunities
00:01:25
Speaker
got to let Dr. No save some lives this time, but she will be back. She'll be back. She will. And we'll both party with and without her. So, you know,
00:01:37
Speaker
It's funny you said with and without her because you know she got bad FOMO. Her FOMO. She does. I know. I get it though because I got FOMO too because all of them though. Something's going on and I'm not there.
00:01:52
Speaker
Do you know what immediately came to my mind as your biggest fomo? That was my biggest fomo. I was so sad. I was out for the count. And I was so sad. And then I'm sitting there and everyone's talking about how much fun they were having and all the stories. And all I could do was just sit and smile.
00:02:12
Speaker
Ooh, you know what? I know a close number two for you, not to make you feel bad for the second time you had FOMO. I know a close number two. Which one is that? Remember we were supposed to go on a trip and you got COVID right before the trip.
00:02:24
Speaker
Oh. To Puerto Rico. Oh, yeah. I was so sad. I was so sad. You get COVID right before that big group trip to Puerto Rico. And we were all good, because we needed a test to fly. I think we all, at that time, you needed a negative test to fly. You tested positive, trying to get out of town. I tested positive the day before. And then I'm sitting there plotting with Dr. Sunshine, like, so this was just the rapid. I'm waiting on the send out. I'm trying to do something.
00:02:54
Speaker
But you got COVID. I'm like, listen, you a physician. You a physician trying to rationalize to me why you think your PCR are going to be negative when your rapid was positive. Right. I'm thinking like, but I'm good. Like, I don't have no symptoms. That was hilarious.
00:03:11
Speaker
She called me like, yo, I got COVID. I'm like, dang. And it's not even, and y'all, we were all staying in a house together. Like, we're all staying in the same house. And she's like, man, how can I make this work?
COVID Cancelled Plans
00:03:22
Speaker
Like, how do I? I'm like, uh, you don't go. You don't go. Right. I'm on the group chat. I was so, I was so sad. I took myself out.
00:03:35
Speaker
I was like, oh, man. I was in my feelings. I was like just missing out on Puerto Rico and all the stuff. I was like Drake. I was in my feelings like hard. Yeah.
00:03:46
Speaker
I was real sad. It's OK. Coughing, sick, like, I wish I could go. But there was no way I could go. I was so sick. I was so sick. They would have stopped you at the Puerto Rico TSA, like, pause. Like, um, no, you can't get on this plane. You're looking sick. I'm like, I'm fine. Why are you sweating? Because it's hot. Right. Please, this way. You are feverish.
00:04:08
Speaker
Why are you sweating? Was that a cough? Is your nose running? What is happening right now? Right. Don't mind that. Don't mind that. See my passport? No. Great. Dr. Chris, you've had a couple of FOMO moments, but it's OK because you're here with us today, which is fun. Yes. Yes. And there are always more moments. So. Yes.
00:04:33
Speaker
There are always more moments. That's true. And I'm just trying to be there for all of the moments. Yes. And you know, if I'm not there, you guys are going to know, like, yeah, she's going to wish she was here. Dang, I can still see you when I walk in that bathroom if I close my eyes, though. If that was really bad, I just made it to the one bar and then
00:04:54
Speaker
And I don't happen so fast. It happens so fast. And everybody looking at me like, I'm crazy. Like, sunshine. Like, why are you on the floor? Why are you next? Oh my god. What's wrong? What's wrong? I'm like, y'all.
00:05:08
Speaker
Look, they told me, I was like, what? I was indignant about it. Y'all don't know what y'all talking about. First of all, we just got here. Let's talk about it. We just got here. And my drink is on the way. I haven't gotten my first drink yet. So there's no way.
00:05:24
Speaker
that whatever you're talking about is happening because we just, we're first up. I'm like, I'm about to go sit. They're like, no, no, no, we can't. I'm like, no, no, no. I need to go lay eyes on this myself because y'all lying. She not
Party Anecdotes and Humor
00:05:38
Speaker
that sick. We, I'm gonna get her a drink now. Then I opened the door and I was like, yo, she's done. Yeah, I was. She's,
00:05:50
Speaker
Got back on the bus. I had no idea what was going on. Got back on the bus, fell asleep. Didn't know what was happening. Y'all couldn't just left me on the bus the whole time. I would have been like, no. I mean, we could have, but nobody wanted to be on the bus. We needed you tucked in, nice bed, comfortable. You know what I'm saying? Sleeping peacefully. With a trash can next to you. Yeah. Listen, I would have had no, I didn't know anything. I woke up the next day like, where we at? Oh.
00:06:18
Speaker
Right. When the party is over. Man, party done. Party done. Right. Long time ago. Long time ago. You know, where I felt bad though, when I started to really feel bad is when we went to 80 proof. The next day, the hip-hop brunch with the bottomless mimosas, and we were having a grand old time. Because we're like, yo, three levels? This food? Yes, let's do it. I'm so sick. You still was green. I was like, damn. Yeah.
00:06:47
Speaker
I know. I got high off my own supply. Never get high off your own supply. Come on, New Yorker. I know. I know. I messed up the carnal rule. I know that. I know that. I messed up. We don't got to bash it too much. We had a whole episode where we bashed you. It's OK. It's OK. It's OK. It's OK. Because like Amy Jo said, there will be more moments to be had. I know. We mashed you up without. We did. You know what I'm saying? We did. I was at the Beyonce concert. I was there.
00:07:17
Speaker
You know, there'll be other weddings, I'm sure. Listen, and I'm good for playing in a random impromptu thing. So we about to make it happen. Cool. Because I will catch a flight. And Dr. Chris will catch a flight too. That's true. I will. I will. I'm trying to catch more flights these days because I work too much. You do work too much. You need to sit down. Yeah, yeah.
00:07:42
Speaker
Even though
Lizzo's Influence and Controversies
00:07:43
Speaker
everyone here thinks I don't work enough, but I do go to work, guys. You know, just also. Do you? What do you even want to work? You're funny. No, no, no, no, no. I know you. This is definitely working. I do work.
00:07:59
Speaker
Dr. Chris work harder than me. I don't know about that. Listen, you know, it's all different. We all do slightly different types of work. My work is not like your workday. Right, right, right. You know, it is what it is.
00:08:33
Speaker
Listen, y'all, I'm gonna get ahead of this before Amy Jo popping here. So Amy Jo has been sending me the most insane nonsensical stories of what's happening in the medical field. And I just want to go on the record and say right now that I don't want her to share none of them with you right now. Nothing. None of them? None of them. She been sending me all these posts about all these people in the medical profession doing wild things.
00:09:03
Speaker
And I'm not with it. I'm not with it. So I think it's so good. But I want to know. But here's the thing. I want to I want to share something. I want to share something. I'm not even in charge of the trending, but I'd like to share something nice.
00:09:18
Speaker
So we're all here for the
Celebrating Sierra's Pregnancy
00:09:21
Speaker
health of black women and black women pregnancies. I just want to say that Sierra is pregnant yet again. And I'm happy for her. Yes. I saw it. Maybe number four. Maybe number four. I'm like, oh, this is great. I'm here for it. She posted her whole little video where she was like moonwalking and stuff. Dancing. Yes. So cool. They're so cute together, though. They are cute. OK, Sierra. I am down.
00:09:44
Speaker
I'm like, I'm over here wishing her a happy and healthy pregnancy. And I'm like, OK, baby, number four. Right. Yes. She got Future and Sienna and Wynn and whoever this little one about to be. That's nice. I'm happy for them.
00:10:03
Speaker
It was good. You don't have to go back and look at what I sent you to make sure. There were some ridiculous ones in there. Oh, what you sent me? Yeah. No, y'all, there are some doctors out here doing some wild stuff, and these articles are getting crazier and crazier.
00:10:18
Speaker
I won't even talk about this one. This one, the one I will bring up because it came up enough that I had to reach out to the reps to be like, you're going to have to give me a statement or something because
Lawsuits and Diabetes Medications
00:10:28
Speaker
I need it. And so there is a lawsuit out against Ozimpic and Manjaro.
00:10:38
Speaker
Really? Yes. Yes. So there's a lawsuit out. See, why don't you send me that one? That's interesting. You can send me all this other weird stuff. I just knew I sent this to you. And they're suing because they are claiming that the Ozimpic and the Monjaro are causing gastroparesis or paralysis of the stomach. Oh.
00:11:01
Speaker
Yes. So that is the, that is the most recent lawsuit. So I think the, there's a lady 44 year old woman that says she had no issues before she started the medication and then she took it and, you know, developed a severe case of gastroparesis, which she's not been able to reverse since discontinuing the medication. So of course she's still in. And so now here comes, you know, the lawsuits now. Um, I definitely was like,
00:11:32
Speaker
uh hey um nova you you got you got you got something to say you want to um and so they did they sent me um they actually sent me obviously not me personally but i got a response like like two days later like hey dr jones just you know
00:11:58
Speaker
We heard you wanted to send it. And so they are obviously saying, you know, there's always risks of gastroparesis that there have been some studies. And I have not had a chance to read these studies yet y'all. So don't ask me what the study said because I have not read it yet. Like I literally got it today, like in my box. But, you know, of course, based on their study,
00:12:22
Speaker
they're saying that the chance of gastroparesis is very small. Not that it's impossible, but it's very small. So it'll be interesting to see how this plays out over the next year, because you know it's going to be drawn out. That has not stopped people from asking for it, because that is just going to be ongoing. And then one of the other things that became interesting is that
00:12:49
Speaker
My personal company, which in my city was probably the last of the people that were covering weight loss medicines is not covering it under the insurance plan. So in my state, there is not an insurance carrier that covers it. And I think that the issue is that most other states are following suit. So insurance companies have been dropping their weight loss
00:13:15
Speaker
medication coverage left and right. So if you were lucky enough to have it, I think that that has lasted, you know, as long as it's going to, because we're about to see this influx of they're going to stop covering it.
00:13:30
Speaker
Here's a problem, like the immediate problem that I see because, and I don't know the details of how long the patient was on the Ozimpic, how many times she was titrated up, her personal medical history either. When it comes to gastroparesis, if she's, and I don't know how diabetic she is, I don't know where her A1C is, but diabetes itself is a risk factor for gastroparesis.
00:13:52
Speaker
So I'm curious if she stopped the Ozimpic and her A1c went up and maybe she had a little touch of it before, but now she really has it. How much of that could be due to her health conditions, due to the fact that she might be diabetic versus a medication side effect versus, there's a lot of confounding here. There's a lot of possible ways that this can go. But I also don't know if she was on Ozimpic purely for weight loss or for treatment for diabetes and weight loss. I don't, there's a lot of, it's interesting.
00:14:20
Speaker
There's the hard part. And you know, I talk about this a lot, that gastroparesis seems to show up not in my severely uncontrolled diabetic people. It shows up in those A1Cs of eight, nine,
00:14:39
Speaker
It can happen to anyone with uncontrolled diabetes. Technically, it can happen to anyone with diabetes. You could be really unlucky, have an A1C of 6.5 and still develop gastroparesis.
00:14:55
Speaker
But I think people sometimes are like, well, I'm not as bad. I'm not in the red. I'm not cold red on my A1C, so I should be good, should not have any gastroparesis. But that's actually not true. That's not true
Navigating Diabetes Treatments
00:15:11
Speaker
at all. I've seen it happen real bad in cases. And then I've also seen it happen in severe cases. But at that point, it's not just gastroparesis.
00:15:22
Speaker
had amputations, they've got poor vision, kidney failure. So it looks like it's grouped into a bunch of other things, but it's gonna be a really hard thing to...
00:15:35
Speaker
to tease out both in the research and in court because who is the blame? Because at the end of the day, technically anybody taking Ozimpic or Manjaro should be taking it as somebody who has been diagnosed with diabetes who felt their first line of therapy. Yep, I'm with you. Yes. Leave it to Amy Jo with these Ozimpic updates. Man, she giving y'all the good, the bad, the ugly. She giving y'all everything.
00:16:04
Speaker
Well, I want people to know, you know, they have not pulled it from the market, right? They've gone back to look at their studies and they're looking at, you know, the cases of people reporting it and they're not saying anything. But here's another thing, right? This is what I was telling somebody yesterday. I am sure there is, I'm sure that the, well, I'm sure that the symptoms of like nausea, constipation or diarrhea are probably rampant.
00:16:34
Speaker
But this one is on the patient because they won't say anything because they would rather stay on it with the symptoms than to come off of it. Because every now and then I'll have one that somebody will say like, oh man, yeah, it makes me super nauseous. I mean, I'm nauseous for the first three days and the next four days are fine. So I get around to my next one. So I'll be like, whoa, okay, that's not necessary. Let's just come on off of that. I think I'm on the plane. They're like, no.
00:17:04
Speaker
I'm not cutting off anything. That's so very true. I have that all the time. And they're like, oh, you know, I'm getting nauseous for a couple of days. I'm like, so why are we doing this? Like we don't have to do this. It's because they really want to lose the weight so bad that they rather deal with the side effects. I've had one patient, she, she, I literally kept talking to her like, we don't need to do this. Like she's literally needing to take Zofran and anti-nausea medicine every single day sick.
00:17:30
Speaker
because she wants to stay on it because her A1C is so much better on the medicines. And I'm like, you've had side effects with all of the classes of that medicine. Like, it's not for you. Like, we need to stop it. Like, why are you doing this to yourself? And it's because they're so fixated on losing the weight, making sure that A1C, because it does help with their A1C, but it's kind of like, yeah, it helps you, but you can't eat and you're miserable.
00:17:58
Speaker
Right. And that's really not the purpose. And some people do. Some people get miserable at higher doses. Some people tolerate it just fine. But, you know, we can find other ways. Like there's other medicines out there. I mean, they all have something, some side effect that we're trying to avoid. So, you know, if it's an SGLT2, you know, I got to make sure that you don't have yeast infections. But you wouldn't have yeast infections if you ain't had all that sugar in your diet. We're not going to talk about that.
00:18:25
Speaker
Um, but you know, there's always something there's, there's lots of ways to approach, uh, diabetes and treatment, but you know, Ozimpic, Manjaro, Migovi, uh, Saxenda, Trulicity, Ribelsus,
00:18:46
Speaker
all GLP ones. They are relatively new. Dr. Chris, remember when we were first getting the update on Saxenda, we were residents. That's how new this is. So Saxenda was the first thing that came out and everybody was super excited about it, but it was a daily injection. That's kind of falling off. Although I still see people want to hear in there.
00:19:10
Speaker
But these medicines are brand new and we're going to find things as you put them to market. So there's only so much you can study even in a human trial, right? Because you have to keep things controlled so you can make sure that you are measuring correctly so that when you write down the data, you know that everything is good.
00:19:32
Speaker
then you got to put it, you got to put it to market. And so that medicine is going to be put in all kinds of circumstances, situations. It's going to be put up next to different medications, different chronic condition, you know, differentials, like everything, right? And so it's going to really get blended and you really will find out like what's the deal. So this is not actually out of the ordinary. You expect this from new drugs on the market, but, um,
00:20:01
Speaker
You know, we're going to find out. I'm not trying to come off of it, though, so it's fine. They're not going to come off of it. They're just like, give me something. Give me something to help the symptoms. Just give me something to help me with nausea and be like, why are we using the drug to treat the drug? We could just come off of it. We could just come off, but all right. No.
00:20:21
Speaker
And the profile is good, right? So you can drop up to an estimated about two points in your A1C. That's huge, right? If you had an A1C of eight, you could go from moderately high to get down to within gold. It really does do that. I got a few people that are normalized on the GOP ones. A1C is like 5.4.
00:20:49
Speaker
So it works very well for people who are like using it. They're tying it to a healthier lifestyle and everything. So I'm not, you know, I'm, I'm here to give it to you if it makes sense, but it was interesting to see this lawsuit come out. So we'll see how this plays out. Yeah. Um, you know, outside of these streets, uh, this, those out here in these streets getting sued. Oh yes.
00:21:15
Speaker
I'm almost sad about that. I loved her documentary with the big girls and the dance. I thought it was great. I loved it. I think it won an Emmy. Yeah. It was really good. And when she promoted body positivity, it just seemed like it didn't even have that much drama. It just seemed like good, go lucky. Everyone got along. It was really nice to see.
00:21:43
Speaker
Why is also getting sued for sexual harassment? Yeah, so her dancers. So she's getting sued for creating a hostile work environment by some former dancers. So there were both her and her captain
00:22:06
Speaker
of her dance team are being sued because they said that there was harassment, that there was sexual harassment, race, disability, all these
Lizzo's Public Persona vs Allegations
00:22:18
Speaker
things. And I mean, they've got all kinds of like stories like
00:22:21
Speaker
her telling dancers like, you know, being gated too much weight will get you put off the team. There was like forced per them, there was forced visits like participate in like strip color visits and some activities that had gone on there and all these things and that she just kind of created this really hostile work environment.
00:22:42
Speaker
I don't know, but since the lawsuit has come out, then there have been more people that have come out to say, hey, listen, I wasn't involved in that, but that doesn't surprise me.
00:22:54
Speaker
or there was somebody that they were trying to hire. I guess when she was filming her documentary and that person was like, yeah, I only stayed for a week because it was a mess. So this does not surprise me. So there's something happening in Liz Oleskamp and they've got to clean up some things. I don't know, right? I'm sad because
00:23:21
Speaker
You know, we've got this woman that's body positive and doing all these things and just being fabulous and speaking her truth. And then you see this other side. And I think that that, you know, really like is got people torn up. But I will just say that I think in social media,
00:23:41
Speaker
in social worlds, you can only be one thing. And I don't necessarily believe that. I think humans are way more complex than that. So I think she can be both, right? Like I can, I think she could, she could be somebody that's had a vision to want to do, do good things that wants to make sure people, women who are obese or women who are black and obese are seen as valuable physically and all this kind of stuff. Like you can be that and be toxic, right? You can be both.
00:24:11
Speaker
Um, and so you can, you can, it exists. And so I think that, you know, uh, she also works in an environment where the culture is to be abusive to fat black women. So even as you want a thing, you can also learn really bad habits of the industry. Cause I can imagine, you know,
00:24:33
Speaker
what they're saying when the women are lining up for the rap videos. Who knows what that feedback is when they're coming in, right? That's true. I'm sure it's a very cruel world. I think, though, you just were hoping that someone like Lizzo
00:24:49
Speaker
would be really conscious to say in this environment, this is going to be a safe space. And so I think the letdown is somehow she got away from the environment and allegedly did not make it a safe space.
00:25:05
Speaker
and even worse, participated in making it an unsafe space. I think that that's the part that's going to get everybody. So I am hoping that this is an exaggeration, but people are coming out left and right. But what I hope more than anything that it's a learning experience because she still has a lot of influence, which means you can still do some good work and still continue the work of body positivity for obese black women. Hmm.
00:25:36
Speaker
Do you think this might be one of those situations where, you know how sometimes people say the hardest people on you or your own people kind of sort of? Do you think maybe this could be a moment where she knows where she stands in the industry and everything she's gone through to get where she is?
00:25:59
Speaker
And maybe she's over compensating or stepped over a lot of boundaries trying to, I don't want to say whip other women into shape, but kind of like, I don't know. I think, or maybe she's projecting some of what she has personally, maybe she's projecting some of her own insecurities and emotions of what she goes through in the industry on a group of people who now she has a position of power over.
00:26:25
Speaker
You know what I'm trying to say? Maybe. I think so. I mean, none of us know her personally to be real. We don't know her, but I just think that I like to. I like to. I like to know. She seemed I love to be. I love to pick her brain. She seems like a really interesting person. She does. But I think I think it's like you said, she has this vision of what she wanted it to be. And then it's probably coming off like, I don't know.
00:26:50
Speaker
She has these restrictions because it's not like she has big girls. She specifically has big girls. She's not having skinny girls really dancing. Right. But now you have a big girl who has been through a lot on her own in the industry having a major influence on other big girls. Right.
00:27:10
Speaker
Right. Right. And don't get it twisted. Even within this realm of like big girls, and we're seeing more and more of them, right? Beyonce has them on her tour. Lizzo has them. I've even seen some thicker girls, you know, with Meg. Even in the space of, all right, big girls, come, let's do it. It's a very specific big girl. Right.
00:27:38
Speaker
it is a very specific big girl. So they're not opening the doors for all big girls. They're opening the doors for the big girls that have small waist, really big hip size, maybe got a little fupa up there, but that's fine because that little bubble gives you that idea. Got a big butt, small ankles. She could have big breasts or not. You can kind of go either way for that, but they're looking for the big girl that looks like
00:28:07
Speaker
in large version of an hourglass, right? And so, but that's not everybody, right? What about the girls that's just long with boobs? Or what about the girls that's just, you know, short with, you know, no but, right? What about, you know, so many variations of like what women look like. So the system is still biased. Now, one thing I will say to, and this goes to Dr. Sunshine was,
00:28:33
Speaker
One of the girls would be an interview and I can't remember because you know I was paying attention a whole lot and then I got distracted. Per usual. But when the girl, I know, when the girl was talking it was almost like she was kind of saying like yeah Lizzo did do these things. I'm not sure if she knew how harmful it was but she did it.
00:28:57
Speaker
I also wonder if this is Lizzo getting, you know, too comfortable. We've all done it to some degree, right? And you get burned for it and you be like, see, this is what I get, right? You know, the first time you, you know, from an adoption, first time you had beef with an MA because y'all didn't get a little too comfortable. And then you realize like, oh, see, I got caught slipping.
00:29:18
Speaker
So I also wonder if it's something like that, right? Like in your attempt to be all the way real and be open and all these things, you would let people hear your inner thoughts and some of those you should keep to yourself. And remember that even in this, even in your space where this is a, you know, closed space, that it ain't completely safe because these not your people, right? These not your friends. I think, you know, I would say Beyonce and Jay-Z kind of are probably a really good example of people who said it out loud. Like, yeah, we had to
00:29:47
Speaker
We had to change the circle. We had to shrink it down a little bit because it was too much play coming in and out of here. So, you know, maybe just knowing like her audience is also a part of the issue. But, you know, she still has got to answer the question, like, what's the deal? Because there's too many people. Some of her old dancers came out and said, yeah, listen.
00:30:09
Speaker
I'm glad they're doing it. There's the truth to it. But, you know, we just didn't say anything. I'm glad they're speaking that truth. So it'll be interesting to see how this plays out. Yeah. Because, you know, the bigger you are, the harder the fall. Because, you know, you do this, the bigger you get. That's when all these things usually come to your surface.
00:30:27
Speaker
I know, and then it didn't help. I think like the next day, when it really started to hit, on tour for the Renaissance, Lizzo is in her vogue. She dropped the name. Wait, drop what name? Who dropped it? Beyonce dropped Lizzo's name from her, when she's calling all the girls in the vogue. Oh, I see. Yes.
00:30:56
Speaker
I think she put, she took, she put Erica Badu twice, which sounds weird. I don't think we'd have noticed if she hadn't dropped Lizzo's name, like he had been in there, but I've been like, yo, that's what the song say, Lizzo. I'm just saying. Well, listen, that's wild though. Lizzo can bounce back. She can. She can. She will. She will. She absolutely will. But I agree with Amy Jo. I feel like this is a really good learning opportunity for her.
00:31:27
Speaker
Yeah. Mind you, the people on the other side of that lawsuit don't see it as a learning opportunity because it's probably going to cost her some coins and it's going to cost her some embarrassment. It's going to cost her a little bit. But again, you get burned, you learn from it. And Lizzo's young. She got a long career ahead of her. And she's talented.
00:31:43
Speaker
Yeah. And people have bounced back from worse girl. We just got lucky that, you know, we were not think, I don't know. I probably wouldn't be a doctor if I, if my twenties existed in social media, man, I don't, you know, I just, the things that we, you know, participated in were insane.
00:32:13
Speaker
Now, the fact that I didn't even know this was a side note, by the way. Lizzo is 35. How about that? Is she? She sure is. In addition to that, I saw a whole bunch of, all this stuff kept coming on CNN, talking about how Made in America is canceled, because Lizzo was a headliner with SZA. And I'm like, dang, they canceled lots of stuff with Lizzo. And I was like, what's this lawsuit about? But I never clicked on it. But now, here we are. Yeah.
00:32:41
Speaker
Oh, man. Lizzo, if you're listening to this, you're 35. Freeze your eggs, girl. That's what I'm going to tell you. Aimee Joe. Of course. Aimee Joe. Of course. Aimee do nothing about the lawsuit, right? I'm not a lawyer. But you could help her with freezing her eggs. Yes. Freeze your eggs, boo. If somebody's listening that knows Lizzo, tell Lizzo, you tell Lizzo that I said to freeze her eggs. Mm-hmm. Yup.
00:33:10
Speaker
Oh my gosh. That's great advice. I'm never going to stop saying that. That's great advice. Look at that. And it was great. I'm reading Black Girls Must Die Exhausted. I won't. Because, no. That's the name of the book, right? No, I know what you mean. No, I know what you mean. And in the book, ironically enough, in the book, the main character is like,
00:33:39
Speaker
in the opening having a meltdown because she has just left um the doctor and the doctor's like yo you have premature ovarian failure and you need to freeze some eggs like in the next six months and she's just like oh my god i'm 33 i thought i had more time blah blah blah blah and i was like well of course
00:34:02
Speaker
I would end up picking it. And I didn't know what the book was about when I first started. It was just that it was on some black girl reading list. And I was like, yes, I'll do it. And so I'm listening to it. And I'm like, that's interesting. So yeah. The fact that you have the time to sit and read a book, I find that shocking. She said she's listening to it. Oh! I'm listening to it. Because I was thinking that. OK. I was like, you don't read reading books? I was like, that sounds like she doesn't have time for that. I can't even envision you reading a book.
00:34:32
Speaker
Listen, and you know how much I love books. I love books, y'all. I love books. I have them everywhere. I've seen you sit still long enough to have a book in your hands. I don't even remember when that was. Right. Well, one of my good friends put me on Libby.
00:34:49
Speaker
which is a virtual library. So I got me a library card. Okay. And I can check out virtual books and I can listen to them on audio through my library. And I love it because it's free. You know, shout out to, um, social services. You know, this is why we pay our taxes and we vote for people in office that do things like fund library systems. Any of it that y'all need some, you know, help where you should put your money and I get to listen.
00:35:18
Speaker
That was a thing. I didn't know that was a thing either. I got a real question. A real, real, real question. Yes. Before you pick the book that reads to you, do you get to pick the voice that reads to you? No. What if you don't like the voice? What is the voice? Is it a man? Actually, this is a girl. This is a girl who's reading. Okay. But no, you don't get to pick the voice. And what's the fee if you're late?
00:35:46
Speaker
I don't know, but I'm turning it on time, right? Because all I got to do was hit the button. Because I need to know. That is so much fun. But I added to like 21, and that is very real. Why are you already premeditating being late? Because she's not going to turn it in on time. I don't even know. I don't even know how much it's going to cost me. I can imagine in high school Dr. Chris was the person that waited for the amnesty day and took all her late library books in and was like, yeah, I can take them now.
00:36:13
Speaker
Cause I, she had come, she'd gone to the point of no return. Like look, I can't, I can't turn him in now. Cause I don't even know. I don't even know what a book is. So how much?
00:36:24
Speaker
So, so yeah, but yes, Libby is a great app. You know, you can put your zip code in, it'll pull up libraries in your area. And so I created a library card for my local library. Um, I think it's somebody to go over there, like verify, like that it's me, right? Show an ID and stuff like that. And so I check books out in my local library and you know, do that. Like I have one, like get good with money.
00:36:48
Speaker
But I'm on a wait list, because I guess everybody's listening to it. So we're just fine. So I was like, let me check out something else. And so I will pop it in on my way to work. I'm going home. That's so cool. I'm going to set this up, because I didn't even know that was a thing. Now I'm excited about this. That's cool. I'm trying to.
Balancing Work and Creativity
00:37:09
Speaker
I am trying to do things that are not always medicine all the time. Now, this is different because this is fun because we've been here talking about everything, but you realize in between our recording, the only thing that happens is
00:37:26
Speaker
I get up, I go to work, I come home, I continue to work, I work till I'm tired, I go to bed, I get up, I go to work. You kind of get to that routine. And it's just all thing you talk about. It's the only thing you know, right? There's no creative juices flowing. And the other day I was like, man, I miss my creative juices. And I was like, well, maybe your juices are not creative because, well, you don't listen to anything else but
00:37:50
Speaker
patients talk about stuff. In these days, because they have you so swamped, you don't even get to listen to like,
00:38:00
Speaker
medicine stuff, right? Like not even a, you know, podcast on like medicine, not a CME or anything. So the only time I get to do CME is if I'm up against a deadline and I got to renew my license, or you got to get your, you know, your DEA license updated or something. And I'm just like, man, I miss exploring. Or you can come to Chicago with me and Chris and Dr. No-No for, you know, Chris.
00:38:30
Speaker
I'm going so I wanted to go because I wanted to complete my Fellow get them CMEs. I'm getting them CMEs red. Um Yeah, I can't work and a week off work in October. Yes. Oh What's happening let Let me let me see something. Oh, you're going to see usher you are so girl. I might go to FMX I'll take a week off and go to FMX. I
00:39:00
Speaker
Listen, think about it. Y'all do it. By the way, Usher's new song is dope. Let's tell the AEP that the chocolate MDs are going to be in town, see if they want us to... They're not going to have us as a speaker for nothing. They don't think they want to do that. What? They're not. How to make, you know, how to bring medicine to the masses. Y'all going to give me some serious FOMO.
00:39:24
Speaker
I'm sorry. I'll tell you if I'm going through that. No, no, no. We got to pitch it. We got to pitch it for the next one. You know, they already got these pictures for this one. We get a picture for the next one. You're right. And don't let the next one be on this. I mean, Arizona or something. Oh, man. Why they always sending us to the middle of America, man? Like, I feel we get we get one cool city and then it's like back to middle of America. We had D.C. last year. Yes. Oh, that is true. You were the only one to win, but your husband came with us. We had a good time. Mm hmm. That is true.
00:39:53
Speaker
I didn't go. Yeah. That's very true. You missed out. I know. I did have FOMO from that. He's talking to me. He's kicking it. Yeah. Listen, he was like, yo, we ain't got this kind of food in Cali. Let's do it.
00:40:07
Speaker
We had a good time. We did. We had fun. That was fun. The food in California is too healthy out here. Lots of grats of granola and avocados and stuff. They're trying to keep you alive. God forbid. God forbid. They're trying to keep you alive. They're trying to keep you alive. Eat healthy. Is there a vegetarian option? Is there a vegan option? Is there a gluten-free, vegetarian, vegan option?
00:40:34
Speaker
You know, I will. I will come to Chicago. I don't think the Hub is going to make it because he's allowed to work, but he'll be okay. Listen, I put in my little request at the job. Be like, listen, this is academic. I will not be here. Figure out what to do with these patients. You have enough time. Figure it out, Brett.
00:41:02
Speaker
today. Y'all. The girls don't even know what the topic for today is. I don't. I'm like waiting like, Ooh, what's the topic? Listen, it's not going to be extensive. It's not going to be long. It's not that involved. It's something real simple. It actually came to me today and I was treating one of my patients. So I want to have a brief talk.
00:41:21
Speaker
about the immune system. And I want to talk about this because whenever we do your blood work, at least in my office, there are a series of blood tests that we order that's part of like a standard panel.
Understanding CBC Tests and White Blood Cells
00:41:39
Speaker
And one of the things we order with a standard panel is something called a CBC. It stands for complete blood count. It's one of the tests we order.
00:41:49
Speaker
Keeping it real simple for y'all, the CBC basically tells me two major things. What's going on with your red blood cells? What's going on with your white blood cells? The red blood cells are the ones that are responsible for the actual blood that you have in your body. How much oxygen is your body getting? Are you low on blood? Do you need a blood transfusion? Are you anemic? Do you have enough blood for your body to function? Those are the red ones.
00:42:16
Speaker
What I'm talking about today are the white blood cells. Those are the other ones on that test. Your white blood cells are super important. Your white blood cells tell me about your immune system. This basically tells me, hey, what's your immune system doing? And we like this number to be like Goldilocks. We like it to be just right. Because when the number's too low, we got problems. When the number's too high, we got problems. We like the number to be right there in the middle.
00:42:45
Speaker
Now, what does middle mean? I can only speak for my lab and where I work. So where I work, normal is anywhere between 4 and 11. Period. That's our cutoff. 4 and 11. If the number- It's a good generalization. I think 4 and 11 is probably a good generalization across the board.
00:43:04
Speaker
If your white blood cell count, that WBC, if it is below four, that tells me something with your immune system is off. You are not as prepared to fight off bacteria, viruses, parasites, anything. Your immune system's low. Why is it low? I'm not sure. But that number's low. Your shield is down.
00:43:28
Speaker
Between four and 11, we're good. Above 11, if that number gets high, it tells me you might have an infection. You might have cancer. You might have some things going on that prompts your immune system to kind of be on overdrive. So high isn't too good, low isn't too good. We want to just write. What's up, Dr. Chris? Well, I was just going to say that you made a big point and say your lab cut off because you have to also understand certain labs have different cut offs. So you might be a little bit lower, but that doesn't necessarily mean it's a problem.
00:43:58
Speaker
It's just people, the lab cutoffs are just slightly different, right? So I just wanted to just throw that out there. Yeah. And also Dr. Sunshine is saying, you know, if it's too low, you got an issue. If it's too high, you have an issue. But that does not mean low and high don't mean the same low and high in all circumstances.
00:44:20
Speaker
Because sometimes I'll get patients, they'll say, hey, did you see my CBC? It's high, the number is red, it's high. And it'll be like, I don't know, let's say the cutoff is 11.2, it'll be like 11.8, or it'll be 12. And honestly, an isolated elevated count or an isolated low count, that's like,
00:44:43
Speaker
a hundredth of a point off or one point off may not get your doctor's full attention because we could catch you in the middle of things, right? We can catch you making white cells at some point or making red cells and sometimes in the setting of not looking like you have any effects or anything like that, that number being slightly elevated is not going to trigger a gigantic workup.
00:45:06
Speaker
Right. And sometimes I have to say, like, in my clinic, sometimes like if someone comes in and they're going to get blood work, but they're getting a vaccine, a lot of times they give the vaccine before they take the blood work. And so then you see sometimes a dip in the white blood cell, but it's kind of like your body's reacting to having the vaccine and it could be other things. So what what I'm saying is that there could be like Amy Jo said, there could be different circumstances to explain why you have
00:45:36
Speaker
slight changes, but it's not necessarily alarming. Right. And I'm bringing up this topic because now that you guys have access to all these portals, and you guys love to go on these portals and look at your labs, and as soon as you see a lab that's a little too high or too low, you are immediately messaging your doctor. You're messaging Amy Jo, you're messaging Dr. Chris, you're messaging Dr. Sunshine, like, hey doc, what does this mean? What does this mean? What does this mean?
00:46:03
Speaker
I a thousand percent agree with Amy Jo, because if I get a white blood cell count, WBC, that's how it shows up on your little portal thing. If I get a WBC count and it is abnormal, and if I'm really concerned about it, the first thing I'm probably going to do is repeat it.
00:46:23
Speaker
Because patients are like, oh my gosh, did you see this number? What we going to do? What we going to do? What we going to do? I'm like, we'll repeat it. And they're like, when? I'm like, eh, like a month, maybe two, maybe three. We'll repeat it. Because one isolated elevation or one isolated low number is not the tell-all of what's actually going on. I might also ask you some follow-up questions. If that number is high, I'll ask you. I'm like, hey, how do you feel?
00:46:47
Speaker
You got a cough, you coughing up some phlegm, you got pneumonia, you got a UTI. I'll ask you some follow up questions like that too, because those do matter. Because you might actually have an infection. That is true. But if you don't have any fevers, if you don't have any fevers, you feel good. All's great. You're like, nah doc, I feel great. I'm like, all right, cool. Well, then we'll repeat it and we'll see. Now, I will let you know this. If we repeat this number,
00:47:12
Speaker
And a lot of times, if I repeat your number, especially if your number is low, if I repeat it again and it's low again, then that can actually prompt me to want to do a workup, as in prompt me to order more labs, maybe consult a specialist. A lot of that depends on how I personally feel. It depends on what the patient tells me, because there are certain things that can cause your white count to be low that are in your control, you as a patient.
00:47:40
Speaker
because your white count can take a dip, number one, if you are stressed, they can take a dip. If you're stressed, if you're not sleeping well, if you're not eating properly as in not getting your daily multivitamins, there are certain things that can cause your immune system to dip. And a lot of those are in within your power. And some of you may also notice, especially when you're really stressed, more than likely, y'all tend to get sick when you're really stressed because your immune system is just not operating on four cylinders. It's just not.
00:48:10
Speaker
Yeah. That's probably one of the most common things. And the problem is that when I talk to my patients and I'm like, oh, doc, well, I'm all of that. I'm stressed. I'm not sleeping. I'm not eating right. I'm not this, I'm not that. I'm like, okay, well then let's give you some time to fix that. And then we'll repeat this lab in three months or we'll figure it out. Because a lot of times it's not always, oh my gosh, do I have HIV? Is it leukemia? Is it this? Is it that? No, no, no, no, no, no.
00:48:35
Speaker
because that's what Dr. Google told you you might have, right? It's not always that. Yes. If it's slightly elevated, people will call and be like, do I have leukemia? And I'll tell y'all only because when you see leukemia, you can't forget it. You don't have a little bit of a white count when you've got a blood cancer. It comes back like 50.
00:48:57
Speaker
You're supposed to be no higher than 11. Maybe we'll give you 12 or 13 on a good day, but yours is currently 45 or 60. Then we are like, okay. And you typically tend to have symptoms.
00:49:12
Speaker
Like you don't typically come in and you're like, oh, I'm fine. And then it's just like that, right? You're feeling weak, you're feeling tired, you're losing weight. Like there's other things. So that's why it's kind of like all of those questions are important. Cause if we see something and you don't have symptoms, you know, depending on how high it is, how low it is, we might not be all that alarm. But if you got symptoms, then I'm thinking a little differently.
00:49:38
Speaker
Yeah. The symptoms are key. Dr. Chris, that's a great point. That's a great point because the symptoms, the symptoms will help to guide us, but the symptoms help to guide any doctor across the board, you know? Yeah.
00:49:54
Speaker
I'll touch on this a smidge. But if for some reason we do need to get a specialist involved, that specialist is called the hematologist with an H hematologist. And one thing hematologists love to do is draw blood. So they're probably going to have you draw a ton of labs, probably do some extra labs and blood smears and things to basically rule out all the stuff that Dr. Google told you you might have.
00:50:18
Speaker
And then ultimately they pretty much take it from there if we're really thinking that you have something really concerning happening with your immune system that's beyond our personal scope.
Impact of Steroids on Immune System
00:50:29
Speaker
Another thing I want to bring up here is something that can also affect your immune system also is if you're on steroids.
00:50:36
Speaker
And steroids, steroids, and that doesn't mean like, you know, the steroids that athletes take, or I mean, those two. But I mean, like, even if you take a steroid burst, because you have like an asthma exacerbation, COPD, if you're on steroids for lupus, or any autoimmune condition, any steroids can impact your immune system across the board. And that is very, very common. Very much so. True.
00:51:03
Speaker
So there's other factors and things that can be influencing your immune system, which is why when we see it, hopefully we're talking to you on the phone and we can go through your labs with you, but we're really trying to rule out the common things first. Like let's improve your stress. Why don't you get some sleep? Take a multivitamin. Oh, you just had a steroid burst because you had an asthma exacerbation. Cool. Stop taking the steroid. We'll repeat it. We'll see where this goes. Everything is not always an emergency and it's not always cancer.
00:51:33
Speaker
And I think really people really undersell like
00:51:38
Speaker
I was just saying this in my office to a couple of people that people really do underestimate what happens to the body when the lifestyle is not good, right? So when you're super stressed and you're thus eating poorly and so you're not seeing the numbers or you're not sleeping well, most of your system repair, system reset happens while you're asleep, right? You start making cholesterols for hormones in your sleep
00:52:07
Speaker
And so to not get that good sleep quality, you're not really doing any maintenance. You don't ever like going to maintenance mode. You know how when you work in an office and they be like, please leave all computer devices on because at 12 AM, we're going to start to run the maintenance check. You never get to run your maintenance check because you're not resting.
00:52:37
Speaker
And I mean, one of the important questions that I ask patients, anyone that see them, especially if we're going through our annual physical, I'm always asking you about your sleep, and your stress level, and how you deal. Because all of that stuff is important.
00:52:52
Speaker
I think people like, okay, sleep, I sleep okay, I guess. And I always ask follow questions because it's important. You wanna lose weight, you gotta be able to sleep. You need to sleep. It's not gonna work, right? If you're depressed and you're sad, I'm asking, are you sleeping? Because that impacts it. You have anxiety, do you sleep? Maybe if we fix your sleep, you might not be as anxious. It's really important. And I don't think people understand
00:53:20
Speaker
why a lot of my patients like, she always asks me about my sleep. Yeah, cause it's important. Cause it affects a lot of things, right? It does. I feel the same way about stress. And then, and then when they start asking me like, Oh doc, why are you asking about my stress? I'm like, well, because stress, if you're under a lot of stress creates a hormone called cortisol and cortisol has a lot of effects on a lot of other things in your body, which can also impact all this other stuff we're talking about.
00:53:46
Speaker
Right. And mess up your immune system and you get sick. Mess up your immune system, raises your blood pressure, increases your blood sugar. Of course, all out here messing up everything. So if you told me that, it's not. If you're over here like stressed and stressed because of anything, work, family stuff, you taking care of your whole family and your parents and your kids and listen, it's a lot.
Stress and Health
00:54:08
Speaker
And then you ask them, are you stressed? And they're looking at you like, of course, I'm always stressed. I'm like, facts, I get it. But you got to find ways to reduce it. Chris said facts. I mean, you got kids, you a single mom or like a family, a husband. I mean. Trying to pay bills. Trying to pay bills, right? You taking care of older family members, right? You taking care of your parents. They're like your extra kids.
00:54:38
Speaker
Right. It's true. It happens. Not extra kids. They are like extra kids because you know they're older and you know. That is such a good description.
00:54:53
Speaker
It's extra kids, but not kids that you raise. It's kids that don't raise themselves. Right. Right. And you've got to deal with them. And you tell them that they can't be by themselves and they're looking at you, but I can. And you're like, what you mean? You can't live in this house. But they don't want to go anywhere. They don't want to live with you. So you've got to figure it out. That's stressful.
00:55:13
Speaker
And they only want you to take care of them. They don't want nobody to come in there and help them. And it's just like, that's a lot. You're like, no, thank you. You're right. You are so funny. That is surprisingly accurate. I mean, especially we get older, the more stress, right? But then how do you deal with it, right? What are you going to do? Are you going to drink? Not necessarily a healthy way to deal with your stress, but that's what coping mechanisms, right?
00:55:44
Speaker
It's funny how this immune system talk has turned into a stress talk. I know, right? A stress talk, a sleep talk. It's all wrapped in. It's all wrapped into it. But I do want you guys to remember that when you get these labs back in your portal to not jump to these crazy, crazy conclusions and don't feel the need to frantically message. I mean, you could shoot a message to your doc, but don't frantically message thinking that you have this really obscure thing that you Googled.
00:56:10
Speaker
Uh, cause it's probably not true. You know, you might just, you might just need to improve your lifestyle, especially if your white count used to be normal, you know, at baseline, you're probably just a little off and just recent to yourself and you'll be fine. I don't have much more than that to be real. I told you I was short. That's good. But I think those are helpful because sometimes, um, I, you know, by the time I get to a message and it's a question about labs, right? If you didn't, cause they're scared and if you didn't respond back to it, um,
00:56:42
Speaker
in 30 minutes because they're like, this thing is off and I've looked on Google and Google has told me all these things. So do I have cancer? Like, what is it? Like, please get back to me. You're like, okay. So it's kind of nice to have these conversations because it kind of, you know, it helps patients when they're looking at it because you're stressed, you're waiting for an answer for me. I can't get back to you that fast. And so it makes the whole experience like horrible. And I'm like, oh,
00:57:08
Speaker
Does it? Oh, I ain't nothing to see here. And they're like, what do you mean it's nothing to see? Like, yeah, I'm not really worried about it. That's the worst thing patients like. Yeah, they don't like that. They don't like that. What you mean you're not worried about that? What does this thing mean in my blood count? And then it's like they fail to read that little part. All the other things that might be elevated, that's not clinically significant. Kind of like don't worry about it. You don't read that part because they because we run this complete blood count and it shows us like all the stuff in the blood, but not
00:57:38
Speaker
everything necessarily matters to us. True. So they're looking like, what does this mean? Why is this elevated? What's my MPV? Yes.
00:57:52
Speaker
I'm not worried about it, so don't worry about it. And you try and explain it to them, but it's elevated. Okay, but everything else is good. But if it wasn't important, why would they list it? Oh, okay. Well, it's in everything. They're testing all of it, so like, okay. And it's in context of a lot of things. Right, so it's like something, one thing might be elevated, but we look at the whole picture, right?
00:58:20
Speaker
It's not just one thing. And that's why we went to school for so many years. We had to learn all of these things and put it together. Half of our learning is to learn when something is not important. Yeah. That's true. It's like, oh, no, no, no. I know enough and I am educated enough to know that this is a non-issue. This is not important. Right. I've seen enough urgent things to know that this is not urgent.
00:58:50
Speaker
And if I'm worried about it, I'm letting you know. I'm doing something. If I'm worried, you should be worried. If I'm not worried, you Gucci. You know, you can't tell your patients that. Some of my patients I do talk to you like that. They trust me though. They'd be like, they'd be like, okay, Dr. Sunshine, no, I'm with you. You ain't wearing eyewear. Listen, we good. I'm like, okay, cool. Yes, they do do that. It's so cute. But I don't necessarily say I'm worried. I say I'm concerned, right?
00:59:16
Speaker
I'll be like, I'm concerned. You know, you know, you know, a phrase I use a lot, no phrase I use a lot from going over their labs with them. I put them on the screen. I'm like, you know what? This makes me raise an eyebrow. And I don't like that too much. They're like raise an eyebrow. I'm like, yeah, because it's not supposed to be there. Yeah. And another thing too that people should understand is we look at trends too. So if one thing is elevated, we're probably looking at past labs to see, well, is this your trend? Is this normally like your
00:59:43
Speaker
low or is this something new? That also helps us to determine what's the next step or should we be concerned or not be concerned. Yeah, because this might be your normal. Right. Because some people, their white blood cell count is just a little bit below the normal and it just is consistently that way. And so therefore, we don't do anything. And maybe you did have a consult with hematology years ago
01:00:11
Speaker
and they said everything is good, right? So if all of that is happening, you're within that same range.
01:00:29
Speaker
What you got for the questions, boo? So listen, y'all, these questions... Y'all see how her voice changed? No questions? It's the questions. We have... It's the questions. What is the questions? Who is the questions?
01:00:47
Speaker
Pause, Amy Jo, why you got your influencer lamp on? What happened? Look at you, look at you. Oh no, it was, that's my screen. Because I'm not looking at you right now. I am looking at our spreadsheet with all of our questions. Oh, gotcha. And it's giving me a little social media glow. Influencer glow. I was like, ooh, she turned on her influencer lamp. Right, let me get into it.
01:01:15
Speaker
I got to get one. I do. I do want to get one, though, especially if we go live. So don't get your hopes up, folks. Don't do that. Dr. Chris gonna fight it. Dr. Chris gonna fight it.
01:01:31
Speaker
Probably shouldn't. Yes. Yeah. And showing people our actual faces and things. Probably shouldn't. Probably shouldn't. All right. You're too much for me. This is a good question. Somebody literally just asked me this question today in clinic.
Colorectal Cancer Screening Options
01:01:45
Speaker
What's the question? The question is, what are your thoughts on colonoscopy screenings versus the yearly poop tests I have to take home each year? Which is better?
01:02:03
Speaker
Well, if you are a patient and you are not considered average risk, you don't really get a choice because you get a colonoscopy. As in if you have colon cancer in your family, especially if your mom, dad, sibling had colon cancer, you're getting the scope and you're getting the scope early likely for the average regular folk.
01:02:24
Speaker
Um, I think it's a very, I think it's a very good question. I think that the colonoscopy itself does come with a small level of risk because it is a procedure, but the colonoscopy itself, assuming that they have a clear view of everything is a really, really good way of kind of, you know,
01:02:42
Speaker
It's a very definite way of saying, hey, we looked at everything. It looks good. Or hey, it doesn't look good. We took a biopsy. And I think it's very, um, it gives my patients a lot of closure because they have the scope and they're like, awesome. Somebody looked, this is what they saw. That makes me feel great. When are we doing it again?
01:03:02
Speaker
Some people are like that. Other people aren't built like that. Other people are like, listen, you're telling me they don't have to go up my behind and put a scope where the sun don't shine? Cool. I don't want to know way. You got a test? I can just kind of make sure it doesn't see anything, abnormal blood, anything like that. Cool. I'll do that.
01:03:21
Speaker
But when it comes to the screening test for the fit test, or there's a fit test, there's a cola guard, there's a couple different types. It is a screening test, which does mean that there is a small chance that it may miss some people. But that's with any screening test, not just that one. Any screening test we have, there is a level of
01:03:42
Speaker
ability to miss some people, as in a false negative. So there's a pro and a con. And there's also false positives too. Yes. So that also can happen. But I mean, in my experience, when people have done the Cologuard, that's when they test the stool and that one is good for three years.
01:03:58
Speaker
Whenever it's come back positive and someone had to do a colonoscopy to reach out to see, there's usually Apollo that's present. So in my experience, I would say that they're both really good tests, high specificity and good sensitivity. But I mean, the colonoscopy, it's like the only real screening test that we have that if they see something, they can clip it and literally prevent cancer from growing. Right.
01:04:28
Speaker
So, and if, you know, they don't see anything, you're good for 10 years. If they see something, depending on what the pathology of that polyp is, because not all polyps are cancerous, right? Depending on what it is, you know, they go in and they, they can clip them some more because some people who just have polyps, they go back in again and they get more polyps. Yeah. And they have to repeat sooner, possibly repeat in three or five or seven, whatever they decide based on what they see. That's very true. Yeah.
01:04:58
Speaker
And as far as bad risks, I mean, there is always that risk of perforation where they can, when they go in with the camera, that they can like literally kind of like put a hole in your, in your colon, but that's kind of like rare. I don't see that happen very often. I'm not seeing it.
01:05:16
Speaker
So it depends on, so I think we say all that to say depends on where your risk aversion is, right? Like some people, especially when the pandemic hit said, I do want to get my colon cancer screening. I do not want a procedure. I sent them a Cologuard. All these are FDA approved to be screened, to be used for screenings for cancer.
01:05:39
Speaker
it just depends on which way you're using. Technically, if you use the fit test, which is what you're talking about, the little stool samples they see you home with every year, if you use the fit test, you just have to repeat it every year. So every 12 months, you'd have to do a new fit test. If you use the Cola Guard, which is the little kit they sent to your home, if you ever seen a little commercial, a little box dancing in the swimming pool, I don't know why those match, but that's what they're doing. But that is the Cola Guard, and as long as that one is normal, you do that once every three years.
01:06:08
Speaker
The cool thing about the colonoscopy, it's going to be one of three things every three, five or 10 years, it's kind of depending on what they find. If they find nothing and everything is perfectly wonderful, then we'll see you in 10 years. If they find a polyp or two, they may say, hey, can you come back in five? And sometimes if they find a polyp of three or four, they'll say, come back and see us in about three years and they'll be fine. Either way, it's whatever fits your tolerance, your scheduling and all that stuff.
01:06:38
Speaker
But the point is you should get screened. I will also, I usually also let my patients know, especially my patients that have a history of hemorrhoids, especially hemorrhoids that are not very well controlled in a history of constipation, that sometimes they can have bleeding from the hemorrhoid and it can possibly make their fit test positive. And then they have to do the scope and the scopes will be completely normal with the finding of hemorrhoids, of course, which they knew they had already. So that's, that's something that can also happen too.
01:07:07
Speaker
Yeah, I think they also said if you have a history of IBS, things like that, that you need to colonoscopy and not do the fit test or the cola guard for the reason that it could have maybe a false positive or something. A false negative. I can believe that. But please get your screening.
01:07:29
Speaker
Right. What's most important is that you pick one to get your screening. This is what I told my, one of my patients just earlier today, cause she was like, tell me if you want to pick. And I was like, listen, you can pick either one. What I'm concerned about is have you been screened period, which one you use to screen.
01:07:45
Speaker
I don't care. Yeah, I told that to my patients too. I'm like, I gave you the two choices. They're like, which one? I said, it don't matter whatever you pick. All I know is that you live in here with some type of screening option. So figure it out. And we screen earlier too. We screen earlier too. Yeah, we don't screen at 50 anymore. I know older people talk to themselves like, oh, 50, you know what that means? Like, no, no, no. We screen earlier than that. So we screen at 45, y'all.
01:08:09
Speaker
And listen, people, if you do have a first degree relative that had colon cancer, even if you don't remember the age, tell your primary care doctor. Because in most cases, we would screen you 10 years earlier than the start time. So these days, that means that some of you all could be due for your first colonoscopy at 35. Yep.
01:08:35
Speaker
So this is not for all of our seasoned patients. Like some people need to have one while they're still pretty young. And so if you're unsure about it, just ask, hey, this is who in my family had colon cancer. Do I need to go early? If we as primary care doctors don't know, I will sometimes where it's like, that doesn't qualify, but I hear what you're saying. I will still put a referral into gastroenterology.
01:09:04
Speaker
And they'll know, too, because I've seen them say, no, I actually want to screen this person. I'm going to do this colonoscopy. And I've also seen them say, you know what? We'll be all right if we wait two more years until year 45. Yeah. I'm with it. Yeah. But thanks, guys, for the question. Yeah, you guys should send more questions. Since Amy just said they're anemic, please send us more questions. Please. And thank you. And then that's all we got for y'all.
01:09:33
Speaker
But listen, ah, Dr. Noah's not here. So listen, guys, we do need your questions. Please send them. If you do not know how to find us, you can find us on all these internet streets, okay? We have a Facebook page. You can find us at the chocolate MDs.
01:09:50
Speaker
um x you can find us at the chocolate mds spill you can find us at the chocolate mds instagram you can find us at the chocolate mds we also have a website www.thechocolatemds.com you can ask those questions anywhere you can send us dms you can do all the things or you can just come check us out listen to old episodes see what we're doing see you know what topics recovery and all that kind of good stuff
01:10:16
Speaker
and we will go from there, okay? So keep up with this peeps. And you can send your questions to thechocolatemds at gmail.com. Y'all know we had a Gmail, but you can email them too. Either way, you need to get them to us.
01:10:32
Speaker
I don't care how they get here just get here if you can yes y'all have a good night whenever y'all listen to us have a good day okay bye y'all